A Bold Proposal for Advancing Population Health January 5, 2014 | Author: Stephen Shortell In his discussion paper, Stephen Shortell identifies a key requirement to move us from being a culture of sickness and care to being a culture of health: making changes in how we pay for health. To effect this transition, the nation needs partnerships that transcend sector boundaries and cultures, beginning with the three sectors that are most relevant: health care delivery, public health, and community and social services. Although paying for accountable care, as called for in the health care reform legislation, is a start, it is not enough. Dr. Shortell identifies the four components — strategic, structural, cultural, and technical — that need to be addressed in guiding the implementation of paying for population health improvement through cross-sectoral partnerships. View the discussion paper.. Shortell S. A Bold Proposal for Advancing Population Health. Institute of Medicine Discussion Paper. 2013 July 24. Available from: http://www.iom.edu/Activities/PublicHealth/PopulationHealthImprovementRT/BoldProposal.aspx.